Nicola Galea MD, Presenter: Nothing to Disclose

Iacopo Carbone MD, Abstract Co-Author: Nothing to Disclose

David Cannata MD, Abstract Co-Author: Nothing to Disclose

Luca Bertaccini, Abstract Co-Author: Nothing to Disclose

Giuseppe Cannavale MD, Abstract Co-Author: Nothing to Disclose

Roberto Passariello MD, Abstract Co-Author: Nothing to Disclose

Carlo Catalano MD, Abstract Co-Author: Nothing to Disclose

Many systemic congenital disorders are associated with aortic abnormalities and MR Angiography could be considered for screening of this population. Our aim was to evaluate the feasibility of unenhanced MR angiography (UMRA) with steady-state free procession (SSFP) sequences for measurement of thoracic aorta diameters and detecting abnormalities, in comparison with standard contrast enhanced MR angiography (CEMRA), in a population of young patients with suspected congenital aortic anomalies.

70 consecutive young patients with suspected aortic abnormalities underwent UMRA and CEMRA in the same examination session. UMRA was performed using breath-hold ECG-gated SSFP sequences covering the whole chest volume in axial and coronal planes. CEMRA was performed with breath-hold 3D Flash sequences in oblique sagittal plane after administration of gadobenate dimeglumine (MultiHance, Bracco) at a dose of 0.1 mmol/kg. Assessment of image quality (3-point scale: insufficient, good, optimal) and measurement of Aortic diameter on both MR techniques was performed at the annulus, sinuses of Valsalva, sinotubular junction, ascending aorta, proximal and distal aortic arch and hiatus. The qualitative scores achieved with UMRA and CEMRA were compared using Wilcoxon’s signed ranked test. Bland-Altman analysis was used to determine inter-sequence agreement for measurements of all aortic diameters. The time for sequence acquisition was calculated.

Qualitative assessment revealed a better image quality of CEMRA at arch and descending aorta, whereas UMRA was better on aortic root, due to cardiosincronization. Bland-Altman analysis revealed high agreement between UMRA and CEMRA measurements at the ascending, arch and descending aorta (p<0.01). Disagreement in aortic diameters was noted at the level of the sinotubular junction, aortic root and annulus (p=0.10). Globally, UMRA required shorter acquisition times than CEMRA (1’23” vs. 9’34”).

UMRA performed with SSFP sequences allows reliable measurements of aortic diameters in comparison with standard CEMRA allowing shorter study times and avoiding discomfort and risk due to contrast agent administration.

UMRA is a reliable method for aortic measurement and detection of vascular anomalies;faster,safer and cheaper than CEMRA, that is preferable to assess dubious abnormalities and atherosclerotic disease

Galea, N, Carbone, I, Cannata, D, Bertaccini, L, Cannavale, G, Passariello, R, Catalano, C, Unenhanced MR Thoracic Aortic Angiography with Steady State Free Precession (SSFP) Technique: Diagnostic Accuracy in Comparison with Standard Contrast-enhanced Angiography.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9011748.html